Spontaneous pneumomediastinum in accidental chlorine gas inhalational injury: case report and review of literature

2021 ◽  
Vol 14 (7) ◽  
pp. e236549
Author(s):  
Safia Akhlaq ◽  
Taymmia Ejaz ◽  
Adil Aziz ◽  
Arslan Ahmed
Keyword(s):  
Emergency Department ◽  
Subcutaneous Emphysema ◽  
Sudden Onset ◽  
Uneventful Recovery ◽  
Shortness Of Breath ◽  
Review Of Literature ◽  
Air Density ◽  
Chlorine Gas ◽  
Inhalational Injury ◽  
Superior Margin

A young man presented in emergency department with shortness of breath and cough after accidental inhalation of chlorine gas. Initial presentation was unremarkable; therefore, he was kept under observation for 8 hours and was later discharged. After 5 hours, the patient presented again in emergency department with sudden-onset shortness of breath and chest discomfort. On examination, subcutaneous crepitation around the neck and chest was found. Chest and neck X-ray revealed subcutaneous emphysema and pneumomediastinum. CT neck and chest was done, which revealed subcutaneous emphysema and pneumomediastinum and a linear air density in close approximation to right posterolateral wall of trachea at the level of superior margin of sternum was reported. These findings raised the possibility of tracheal injury which was later confirmed by fiberoptic laryngoscopy. The patient was intubated due to hypercapnic respiratory failure resulting from hypoventilation and respiratory distress. Bilateral chest tube insertion was done due to worsening subcutaneous emphysema, high ventilator parameters and prevention of progression to pneumothorax. He was extubated after 5 days; bilateral chest tubes were removed before discharge and underwent uneventful recovery.

Facial subcutaneous emphysema in a patient with connective tissue disorder

2021 ◽  
Vol 14 (5) ◽  
pp. e232399
Author(s):  
Jon Curtis ◽  
Nicola Rachel Wooles ◽  
David Phillips
Keyword(s):  
Emergency Department ◽  
Connective Tissue ◽  
Subcutaneous Emphysema ◽  
English Literature ◽  
Connective Tissue Disorder ◽  
Sudden Onset ◽  
Prophylactic Antibiotics ◽  
Ehlers Danlos Syndrome ◽  
Nasal Cartilage ◽  
Danlos Syndrome

A 47-year-old woman presented to the emergency department with sudden onset of swelling in her face, which had been triggered by blowing her nose. She had no other symptoms, but was known to have Ehlers-Danlos syndrome. A CT confirmed bilateral subcutaneous facial emphysema attributed to a defect in her left nasal cartilage. The condition was managed conservatively with prophylactic antibiotics and self-resolved within 48 hours. Only eight cases of sudden facial subcutaneous emphysema following nose blowing or sneezing have been found in the English literature and this is the first known case in a patient with a connective tissue disorder. In this case, her condition is suspected to have contributed to her presentation and may be underlying in other similar cases.

scholarly journals Endometriosis: An Unusual Cause of Bilateral Pneumothoraces

2020 ◽  
Vol 4 (1) ◽  
pp. 35-37
Author(s):  
Christopher Sampson ◽  
Kathleen White
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Respiratory Distress ◽  
Chest Radiograph ◽  
Spontaneous Pneumothorax ◽  
Sudden Onset ◽  
Shortness Of Breath ◽  
Pelvic Endometriosis ◽  
Catamenial Pneumothorax

A 27-year-old female presented to the emergency department with sudden onset shortness of breath. A diagnosis of bilateral catamenial pneumothoraces was made following chest radiograph. Catamenial pneumothorax is a recurrent spontaneous pneumothorax that occurs in 90% of affected women 24-48 hours after the onset of their menstruation; 30-50% of cases have associated pelvic endometriosis. Symptoms can be as simple as chest pain or as severe as the presentation of this patient who was initially found to be in significant respiratory distress.

scholarly journals Aortic Valve Fibroelastoma Masquerading as Transient Ischaemic Attack

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Penelope-Anne Gowland ◽  
Ragheb Hasan
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Aortic Valve ◽  
Papillary Fibroelastoma ◽  
Uneventful Recovery ◽  
Shortness Of Breath ◽  
Transient Ischemic Attacks ◽  
Accident And Emergency ◽  
Ischaemic Attack ◽  
Accident And Emergency Department

The following paper is on a 49-year-old man who presented to accident and emergency department having experienced five hours of left-sided chest pain, tightness in the chest, and shortness of breath. He also reported paresthesia and an ache in the left arm. Further investigations revealed an aortic valve papillary fibroelastoma. Although histologically papillary fibroelastomas are described as benign, they carry with them considerable risk of morbidity and mortality. This patient experienced recurrent transient ischemic attacks (TIAs’). He was taken to theatre on urgent basis to remove the papillary fibroelastoma. His aortic valve was preserved during the operation. The patient had an uneventful recovery following the surgery. His neurologic symptoms resolved following the operation. The operation was curative and no further symptoms were reported at followup.

scholarly journals Metastatic Extraskeletal Mesenchymal Chondrosarcoma of the Pancreas: Report of an Unusual Case with Review of Literature

2021 ◽  
Author(s):  
Saloni Naresh Shah ◽  
Ashok Parameswaran ◽  
Prasanna Kumar Reddy
Keyword(s):  
Unusual Case ◽  
English Literature ◽  
Latency Period ◽  
Sudden Onset ◽  
Mesenchymal Chondrosarcoma ◽  
Pancreatic Tumors ◽  
Good Survival ◽  
Review Of Literature ◽  
Long Latency ◽  
Extraskeletal Mesenchymal Chondrosarcoma

AbstractExtraskeletal mesenchymal chondrosarcoma (ESMC) metastasizing to the pancreas in isolation is a rare occurrence. We report a 49-year-old gentleman who had undergone excision of an ESMC of the thigh in 2009 and presented with sudden onset abdominal pain and icterus in 2019. Radiological imaging revealed calcified mass of the pancreas with multiple nodules with extension into the adipose tissue. Distal pancreatectomy was performed and the pathology revealed a bimorphic tumor composed of undifferentiated round blue cells with abrupt transition to hyaline cartilage, typical of mesenchymal chondrosarcoma. To the best of our knowledge, there are only seven prior cases of metastatic ESMC of the pancreas in the English literature. Surgical intervention appears to be the preferred modality of treatment for metastatic pancreatic tumors. These patients may have long latency period before metastasizing and seem to have a good survival period post excision.

scholarly journals Lipschütz Ulcer: An Unusual Diagnosis that Should Not be Neglected

2021 ◽  
Vol 43 (05) ◽  
pp. 414-416
Author(s):  
Daniela Alexandra Gonçalves Pereira ◽  
Eliana Patrícia Pereira Teixeira ◽  
Ana Cláudia Martins Lopes ◽  
Ricardo José Pina Sarmento ◽  
Ana Paula Calado Lopes
Keyword(s):  
Emergency Department ◽  
Differential Diagnosis ◽  
Clinical Course ◽  
Malignant Tumors ◽  
Sudden Onset ◽  
Drug Reactions ◽  
Genital Ulceration ◽  
Sexually Transmitted ◽  
Inflammatory Processes ◽  
Genital Ulcers

AbstractThe diagnosis of genital ulcers remains a challenge in clinical practice. Lipschütz ulcer is a non-sexually transmitted rare and, probably, underdiagnosed condition, characterized by the sudden onset of vulvar edema along with painful necrotic ulcerations. Despite its unknown incidence, this seems to be an uncommon entity, with sparse cases reported in the literature. We report the case of an 11-year-old girl who presented at the emergency department with vulvar ulcers. She denied any sexual intercourse. The investigation excluded sexually transmitted infections, so, knowledge of different etiologies of non-venereal ulcers became essential. The differential diagnoses are extensive and include inflammatory processes, drug reactions, trauma, and malignant tumors. Lipschütz ulcer is a diagnosis of exclusion. With the presentation of this case report, the authors aim to describe the etiology, clinical course, and outcomes of this rare disease, to allow differential diagnosis of genital ulceration.

Spontaneous perforation of cervical oesophagus: a rare variant of Boerhaave's syndrome

2009 ◽  
Vol 123 (12) ◽  
pp. 1378-1380 ◽  
Author(s):  
S Mittal ◽  
A Rohatgi ◽  
R P Sutcliffe ◽  
A Botha
Keyword(s):  
Vocal Folds ◽  
Sudden Onset ◽  
Water Soluble ◽  
Uneventful Recovery ◽  
Oesophageal Perforation ◽  
Nasogastric Feeding ◽  
Computed Tomography Scanning ◽  
Difficulty Breathing ◽  
The Right ◽  
False Vocal

AbstractBackground:A 29-year-old man presented with sudden onset of severe pain in his throat, difficulty breathing and a hoarse voice, following an episode of vomiting.Investigations:Initial laboratory tests were normal. The patient underwent fibre-optic nasendoscopy, which demonstrated a haematoma in the piriform fossa. Lateral neck radiography and subsequent computed tomography scanning confirmed a 2 cm, loculated, gas-containing collection at the level of the vallecula in the right posterolateral wall, extending to the false vocal folds and communicating between the right parapharyngeal space and the right carotid sheath. Water-soluble contrast swallow confirmed the diagnosis.Diagnosis:Contained oesophageal perforation.Management:Conservative treatment was adopted involving nil orally, intravenous antibiotics and nasogastric feeding. The patient made an uneventful recovery.

scholarly journals BRASH: Case Report and Review of Literature

Hearts ◽  
2021 ◽  
Vol 2 (3) ◽  
pp. 302-306
Author(s):  
Sauradeep Sarkar ◽  
Nicole Rapista ◽  
Amit Rout ◽  
Rahul Chaudhary
Keyword(s):  
Renal Failure ◽  
Case Report ◽  
Predisposing Factors ◽  
Shortness Of Breath ◽  
Review Of Literature ◽  
Vicious Cycle ◽  
Hypertensive Urgency

BRASH syndrome is characterized by bradycardia, renal failure, AV nodal blockade, shock, and hyperkalemia. The proposed mechanism involves a vicious cycle between AV nodal blockers, hyperkalemia, and renal failure and was first described in 2016. We present a case of a 52-year-old woman who presented with progressively worsening shortness of breath and hypertensive urgency who subsequently developed profound bradycardia and shock that was refractory to resuscitative measures, she was diagnosed with BRASH syndrome. In this article, we explore the predisposing factors and challenges faced during the management of patients with BRASH syndrome.

Eosinophilic lung disease as a sequela of MSSA pneumonia

2021 ◽  
Vol 14 (3) ◽  
pp. e239304
Author(s):  
Syed Muhammad Zubair ◽  
Muhammad Zaid Hamid Hussain ◽  
Ali Bin Sarwar Zubairi
Keyword(s):  
Emergency Department ◽  
Staphylococcus Aureus ◽  
Bronchoalveolar Lavage ◽  
Complete Resolution ◽  
Lung Diseases ◽  
Disease Process ◽  
High Grade ◽  
Shortness Of Breath ◽  
High Grade Fever ◽  
Rare Group

Eosinophilic lung diseases are a rare group of lung disorders with multiple known and unknown aetiologies and the diagnosis is often challenging. We present a case of a young man who was admitted with pneumonia due to methicillin-sensitive Staphylococcus aureus and was discharged on antibiotics. He presented to the emergency department approximately 2 weeks after discharge with high-grade fever, cough and shortness of breath associated with serum and bronchoalveolar lavage eosinophilia. He was then treated with steroids with complete resolution of disease process.

scholarly journals Hemoperitoneum due to Splenic Laceration Caused by Colonoscopy: A Rare and Catastrophic Complication

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Shiao-Han Chen ◽  
Jiann-Ruey Ong ◽  
Hon-Ping Ma ◽  
Po-Shen Chen
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Splenic Flexure ◽  
Splenic Injury ◽  
Underlying Disease ◽  
Sudden Onset ◽  
Health Examination ◽  
Asymptomatic Patients ◽  
Grade Ii

Numerous studies suggest that in asymptomatic patients, routine follow-up CT is not indicated due to the insignificant findings found on these patients. A 53-year-old man, who denied any underlying disease before, underwent colonoscopy for routine health examination. Sudden onset of abdominal pain around left upper quarter was mentioned at our emergency department. Grade II spleen laceration was found on CT scan. Splenic injury was found few hours later on the day of colonoscopy. It might result from the extra tension between the spleen and splenic flexure which varies from different positions of patients.

scholarly journals Meningococcemia Presenting as a Myocardial Infarction

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Daniel Lachant ◽  
David Trawick
Keyword(s):  
Myocardial Infarction ◽  
Emergency Department ◽  
Chest Pain ◽  
Cardiogenic Shock ◽  
Neisseria Meningitidis ◽  
Early Recognition ◽  
Myocardial Dysfunction ◽  
Shortness Of Breath ◽  
Gram Negative ◽  
St Elevation

Neisseria meningitidisis an encapsulated gram negative diplococcus that colonizes the nasopharynx and is transmitted by aerosol or secretions with the majority of cases occurring in infants and adolescents. Meningococcemia carries a high mortality which is in part due to myocarditis. Early recognition and prompt use of antibiotics improve morbidity and mortality. We report a 55-year-old male presenting to the emergency department with chest pain, shortness of breath, and electrocardiogram changes suggestive of ST elevation MI who developed cardiogenic shock and multisystem organ failure fromN. meningitidis. We present this case to highlight the unique presentation of meningococcemia, the association with myocardial dysfunction, and the importance of early recognition and prompt use of antibiotics.

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